Smita Jayprakash Shah, MD | |
1805 Medical Center Dr, San Bernardino, CA 92411-1217 | |
(909) 887-6333 | |
(909) 887-9565 |
Full Name | Smita Jayprakash Shah |
---|---|
Gender | Female |
Speciality | Anesthesiology |
Location | 1805 Medical Center Dr, San Bernardino, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255349379 | NPI | - | NPPES |
00A407090 | Medicaid | CA | |
00A407090 | Other | CA | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | A40709 (California) | Primary |
Entity Name | Allied Anesthesia Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346267267 PECOS PAC ID: 6103728407 Enrollment ID: O20040126001001 |
Mailing Address | Practice Location Address |
---|---|
Smita Jayprakash Shah, MD 2923 Bradley St, Ste 120, Pasadena, CA 91107 Ph: (626) 795-6596 | Smita Jayprakash Shah, MD 1805 Medical Center Dr, San Bernardino, CA 92411-1217 Ph: (909) 887-6333 |
Dr. Sakorn Koonopakarn, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 800-883-7243 | |
Antonio Moreno, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 | |
Dr. Samuel J Roth, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 | |
Dr. Benjamin Franklin Davis, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 800-883-7243 | |
Dr. Roman Trochanowski, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 | |
Dr. Mrunal Bhatt, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 800-883-7243 |